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Snapshot
  • A 33-year-old man presents to his primary care physician for a rash involving his left leg. His symptoms began approximately 7 days ago, when he noted a rash. He is unsure if he had any trauma to the leg but states he has had mild fevers. The patient is allergic to penicillin. His temperature is 100°F (37.7°C), blood pressure is 138/88 mmHg, pulse is 98/min, and respirations are 18/min. Physical examination is notable for an erythematous, edematous, and warm lesion involving the left ankle that is tender to palpation. He is started on clindamycin. (Cellulitis)
Introduction
  • Mechanism of action
    • reversibly binds to the 50S ribosomal subunit, impairing bacterial protein synthesis
      • impairs the transpeptidation reaction within the ribosome
  • Clinical use
    • anaerobic infections (e.g., aspiration pneumonia, oral infection, and lung abscess)
      • Bacteroides spp.
      • Clostridium perfringens
      • Fusobacterium spp.
    • staphylococci
    • viridans group streptococci
    • Streptococcus pyogenes
    • Streptococcus pneumoniae
    • group A streptococcal infection
  • Adverse effects
    • Clostridium difficile infection (pseudomembranous colitis) 
    • fever
    • diarrhea
 

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